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COMPLIANCE INFO_2007-2008
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_2007-2008
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Last modified
6/20/2023 10:36:46 AM
Creation date
6/3/2020 9:43:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2007-2008
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_2007-2008.tif
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EHD - Public
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SWRCB, January 2002 Page ` of <br /> 7. UNDER-DISPENSER CONTAINMENT(UDQ TESTING <br /> Test Method Developed By: ❑ UDC Manufacturer t' Industry Standard FProfessional Engineer / <br /> \ ❑Other(Specii ,) <br /> Test Method Used: Ci Pressure ❑ Vacuum Hydrostatic <br /> ❑Other(Spec) <br /> rest Equipment,Used: Equipment Resolution: <br /> UDC# UDC# UDC# DC# <br /> UDC Manufacturer: <br /> UDC Material: <br /> UDC Depth: <br /> Height from UDC Bottom to Top f <br /> of Highest Piping Penetration: �. <br /> Height from UDC Bottom to <br /> Lowest Electrical Penetration: <br /> Condition of UDC prior to <br /> testing: <br /> Portion of UDC Tested <br /> Does turbine shut down when <br /> UDC sensor detects liquid(both ❑ Yes ❑No ❑NA d Y ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> product and water)?* <br /> Turbine shutdown response time <br /> Is system programmed for fail- ❑Yes ❑No DA ❑Yes ❑No!10JNA'N <br /> A EYesO <br /> ❑NAID <br /> Yes ❑No ❑NA <br /> safe shutdown?* <br /> Was fail-safe verified to be ❑Yes ❑Ne' ❑NA ❑Yes ❑No " ❑NA ❑Yes ❑No ❑NA <br /> operational?* <br /> Wait time between applying / <br /> pressure/vacuum/water and // <br /> starting test <br /> Test Start Time: <br /> Initial Reading(Rj): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Change in Reading F-Ri): <br /> Pass/Fail ThreshgA or Criteria: <br /> Test Result: ❑ Pass ❑ Fail ❑ Pass ❑ Fail RNoU <br /> Pass `-❑ Fail <br /> Was sensor eemoved for testing? ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA Yes ❑No ❑NA <br /> Was senstir properly replaced and ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA Yes ❑No [INA <br /> verified functional after testing? <br /> Comments—(include information on repairs made prior to testing and recommended fo/low-up for failed tests) <br /> If the entiredepth of the UDC is not tested, specify how inuch was tested. If the answer to any of the questions indicated with an <br /> ,asterisk(*) is "NO"or"NA", the entire UDC must be tested. (See SWRCB I-G-160) <br />
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